NPIMap

Individual provider Active NPI

Rebekah Bourland Maymani, MD

  • Radiation Oncology Physician
  • Longmont, CO
National Provider Identifier
1164716403
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
59685 Issued in CO
Practice address
1760 E Ken Pratt Blvd Ste 105
Longmont, CO 80504-5311
Phone
(720) 718-5160
NPI assigned
Jun 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 59685 CO Primary

Addresses

Primary practice location

1760 E Ken Pratt Blvd Ste 105
Longmont, CO 80504-5311

Mailing address

366 Blackhawk LN
Lafayette, CO 80026-9392
Phone (405) 593-1384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180910001958 CO Practitioner - Radiation Oncology 2668763467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of North Carolina at Chapel Hill School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

12605 E 16TH Ave
Uchealth Anschutz Medical Campus
Aurora, CO 80045-2545
Phone (720) 848-0000

Hospital & facility affiliations

  • Longs Peak Hospital Hospital, Longmont, CO, CCN 060128
  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024
  • Uchealth Broomfield Hospital Hospital, Broomfield, CO, CCN 060129
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59685COMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince May 1, 2022 Accepting new patients
University Physicians Incorporated CurrentSince May 1, 2022 Accepting new patients
University Physicians Incorporated CurrentSince May 29, 2022 Accepting new patients
Baylor St. Luke'S Medical Group PastSince Nov 1, 2017 Accepting new patients

Locations

1665 Aurora Ct
Aurora, CO 80045
Phone (303) 724-2066

1665 Aurora Ct
Fl 3
Aurora, CO 80045
Phone (303) 493-7245

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Dept 1061
Denver, CO 80256

1760 E Ken Pratt Blvd
Ste 105
Longmont, CO 80504
Phone (720) 718-5160

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIHBCA

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 32

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 32

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1164716403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 BLACKHAWK LN",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800269392",
            "telephone_number": "405-593-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 E KEN PRATT BLVD STE 105",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805045311",
            "telephone_number": "720-718-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYMANI",
        "first_name": "REBEKAH",
        "middle_name": "BOURLAND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-03",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CO",
            "license": "59685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.